What Should People with Diabetes Know About COVID-19 Vaccines and Boosters?

Yes, experts recommend people with diabetes get vaccinated against COVID-19.

These are the COVID-19 vaccines currently available in the United States.

1. U.S. pharmaceutical company Pfizer and its German partner, BioNTech, released their first vaccine in mid-December 2020 for people ages 16 and older. After the first shot, a second dose is required 21 days later. This vaccine was approved for use in children ages 12 and older in May 2021. The Food and Drug Administration (FDA) granted full approval for the Pfizer-BioNTech vaccine in August 2021. It’s fully approved for ongoing use for everyone 12 years and older. A third dose, or booster, is also available for people 5 years and older.
2. U.S. biotech company Moderna released its vaccine in late December 2020. It’s approved for use in adults 18 years and older. This vaccine also requires two shots, with a 28-day period before the second dose. A booster is available as well.
3. Pharmaceutical company Johnson & Johnson (J&J) released its vaccine after getting FDA approval in late February 2021. This one is different than the Pfizer-BioNTech and Moderna vaccines. It only requires a single shot versus two separate doses. It also does not require storage at very cold temperatures, as the others need. Read more details on the J&J vaccine here.

Both the Pfizer-BioNTech and Moderna vaccines are mRNA vaccines. This is a newer type of vaccine that essentially “teaches” human cells how to make a protein — or a piece of a protein — that triggers an immune response inside our bodies.

In turn, this produces antibodies that protect us from developing an infection if the real virus enters our bodies.

The Centers for Disease Control and Prevention (CDC) explains that while mRNA vaccines may be newer to the public, they are not unknown. They’ve been extensively studied for the flu, Zika virus, rabies, and cytomegalovirus.

Coincidentally, one of the key scientists behind the technology driving mRNA vaccines actually lives with T1D himself.

The need for COVID-19 vaccines has become increasingly important, with new coronavirus variants gaining traction and research data showing that unvaccinated people are being hospitalized and dying at a significantly higher rate than vaccinated people.

According to the CDC, COVID-19 boosters are shots that enhance or restore protection against COVID-19. Protection may decrease over time since the first and second vaccine doses.

Short answer: Yes, they are safe.

After clinical trials that included tens of thousands of people, the CDC asserts that the FDA-approved vaccines are safe and effective for most people, barring certain rare allergic conditions.

However, the CDC did issue this disclaimer for people with autoimmune conditions like T1D:

“People with autoimmune conditions may receive an mRNA COVID-19 vaccine. However, they should be aware that no data are currently available on the safety of mRNA COVID-19 vaccines for them. Individuals from this group were eligible for enrollment in clinical trials.”

While some allergic reactions have been reported, severe allergic reactions (anaphylaxis) are extremely rare.

Read this CDC page for more information about COVID-19 vaccines and allergies.

People living with diabetes are not generally considered “immunocompromised,” unlike those who take immunosuppressant drugs, have received a pancreas or other organ transplant, or live with other health conditions.

However, officials do recognize that having diabetes does matter in terms of COVID-19 risk.

The CDC cites numerous research studies showing both T1D and T2D raise the risk of more severe illness from COVID-19. According to one of those studies, T1D specifically presents a potential three times higher risk of more severe illness.

At first, the CDC prioritized T2D over T1D as far as COVID-19 vaccine access. But in April 2021, the CDC revised its guidelines to prioritize both T1D and T2D at the same level.

Per the CDC, both conditions can make it more likely to get severely ill from COVID-19.

This CDC’s change followed months of advocacy, especially from 19 diabetes organizations that signed a letter urging the CDC to immediately prioritize T1D alongside T2D.

The most common side effects of COVID-19 vaccination are not specific to diabetes. They include:

• tenderness, swelling, and redness at the injection site
• fatigue
• headache
• chills
• fever
• nausea
• muscle aches

While experiences of those with diabetes may vary when it comes to vaccine effects, diabetes advocates crowd-sourced this topic to better track what people with diabetes have experienced post-vaccination.

The nonprofit Beta Cell Foundation began collecting data with an online database in early 2021. It gathered hundreds of responses from people who’ve gotten one or both vaccine doses:

• After receiving their first vaccine dose (Moderna or Pfizer-BioNTech), approximately 10 to 15 percent reported elevated blood sugars for a day or two. After their second dose, 23 to 29 percent reported elevated sugars.
• After vaccination with the J&J vaccine, 42 percent had elevated sugars.
• Two percent reported lower blood sugars, and one person reported both higher and lower blood sugars (perhaps a combo of both, due to shifting glucose levels).
• After receiving the second vaccine, approximately 30 percent reported elevated blood sugars, and less than 1 percent reported lower blood sugars.
• No significant differences were reported based on the type of vaccine received, Moderna versus Pfizer-BioNTech.

If someone does have a severe reaction to a vaccine or booster shot, it’s best to consult with a doctor or healthcare professional who knows your health situation.

COVID-19 vaccines and boosters are considered safe. Experts encourage people with diabetes to get vaccinated against COVID-19 because of the higher risk of severe illness from the disease.

While the vaccines and boosters are not guaranteed to affect glucose levels, some people living with diabetes do report minimal changes in their blood sugars.

Each person’s need and timing for a COVID-19 booster may vary. Talk with a doctor if you have any concerns about your diabetes management and COVID-19 vaccination.